COVID-19 Pneumonia Complicated by Seizure Due to Severe Hyponatremia

Abstract

Coronavirus disease 2019 (COVID-19) is a widespread disease. Hyponatremia in the setting of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was described with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Nonetheless, seizure as a prominent manifestation of hyponatremia associated with COVID-19 is rare. We present a case of a middle-aged man with mild COVID-19 pneumonia, who developed a seizure due to SIADH-related severe hyponatremia.

Severe Hyponatremia in the Setting of COVID-19-Associated Syndrome of Inappropriate Antidiuretic Hormone: A Case Report

“…Disorientation, confusion, seizures, stupor, and coma in the absence of respiratory symptoms could lead to misdiagnosis of COVID-19 and delay of treatment resulting in poor outcomes. While several case reports to date discuss this manifestation of COVID-19 pneumonia, none have described it in the setting of patients with underlying alcohol use disorder and cognitive impairment (Table 1) [13][14][15][16][17][18][19][20][21]. These underlying conditions leave the potential for anchoring and can result in a misdiagnosis of the patient's illness.…”

Hyponatremia in COVID-19 Is Not Always Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH): A Case Series

“…Several cases of hyponatremia secondary to SIADH in COVID-19 patients have been reported in the literature [6][7][8][9][10], with most of these cases being attributed to pneumonia as the underlying cause of SIADH [7][8][9][10]. However, others have also reported the development of SIADH in the absence of pneumonia [6].…”

“…While the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) is thought to be the primary etiology in many cases [6][7][8][9][10], the underlying pathophysiology driving COVID-19-related hyponatremia can be varied, and a broader differential should be considered while assessing such patients. A thorough and systematic assessment is required to pinpoint the correct etiology and instigate the appropriate corrective therapy.…”